On Leadership: Lighting the Way for the Future with Grilled Cheese, Candles and Beer

Anticipation for the McAndrews Leadership Lecture at this year’s National Chiropractic Leadership Conference (NCLC 2018) was heightened by the mystery surrounding the title of the talk – “Grilled Cheese, Candles and Beer”—and what it could possibly have to do with leadership. Presenter Stephen M. Perle, DC, MS, a respected author, journal editor, lecturer and professor of clinical sciences at the University of Bridgeport College of Chiropractic, not only served some valuable lessons based on his personal experiences and observations on leading “from the middle,” in the end he gave all gathered plenty to chew on.

Grilled Cheese

“I think we have to redefine leadership,” Dr. Perle announced. “Most of you are, like me, are not leaders in the traditional sense.”

He recalled how his perceptions of leadership changed many years ago after striking up a conversation with a man on a train who taught a class called “Leading from the Middle.” The concept was straightforward: You don’t have to be at the top of an organization to get things done. You can create positive change from right where you are.

“It’s something all of you can do. I realized that that’s what I do,” he said.

Referring to a grilled cheese sandwich, Dr. Perle explained that it’s all about the cheese–which is in the middle. “Be the cheese in the middle, and do things,” he advised the doctors and students gathered at NCLC. “When you’re not a leader, you can think out of the box and do things leaders can’t do.”

He explained how the ACA’s Choosing Wisely recommendations came about because doctors in the field saw an opportunity. They started the ball rolling by reaching out to ACA leadership and starting a conversation about how the chiropractic profession could participate. “Doctors in the middle put [it] into motion, leaders pushed it through,” he said.

“It was the people in the middle who went to [Capitol Hill] today,” he added, referring to the hundreds of ACA members who visited their elected officials as part of NCLC’s Advocacy Day, sharing positive messages and their personal stories to underscore the value of chiropractic services.

And just as melted cheese holds the bread together, chiropractors can be the cheese that bridges the gap between the chiropractic profession and the rest of the health care and research communities. Creating connections that hold these communities together helps create a better future for our profession, our patients and our patients to be, he explained.

Dr. Perle cited the book, Who Moved My Cheese, for the important lessons it teaches about preparing for, and adapting to, change–which is inevitable.


The candles refer to the importance of mentorship, showing the way for others and inspiring them to act. “One candle loses no flame by lighting another candle,” Dr. Perle noted.

“Do you like how the profession is going? Yes or no, you have to be more active. Sitting on the sidelines isn’t going to do that. You need someone to give you a vision of where to go,” he added. “And if you get through the door, you have to help other people through it.”

Candles were also a metaphor Dr. Perle adopted from Carl Sagan, who called science a candle in the darkness. Understanding science will help us adapt to “the moving cheese of change.”


Unlike making wine, brewing beer is a predictable process, Dr. Perle observed. You put in the ingredients as directed, you brew it, and you get a batch of good beer. He noted that by providing the funding for research (the yeast) our researchers (the malt) have produced the research (the beer) that moves our profession forward.

By everyone doing their part, he concluded, the chiropractic profession will be successful too: “Tell yourself, ‘I need to be the cheese. I need to light another candle,’… and we can all brew the future we want.”

Annette Bernat is ACA vice president of communications and external affairs and ACA Blogs editor.

ACA members have exclusive access to video of Dr. Perle’s NCLC presentation. Click here to view.